Are changes in depressive symptoms, general health and residential area socio-economic status associated with trajectories of waist circumference and body mass index?

Abstract

Objective: This study sought to assess whether changes in depressive symptoms, general health, and area-level socio-economic status (SES) were associated to changes over time in waist circumference and body mass index (BMI).

Methods: A total of 2871 adults (18 years or older), living in Adelaide (South Australia), were observed across three waves of data collection spanning ten years, with clinical measures of waist circumference, height and weight. Participants completed the Centre for Epidemiologic Studies Depression (CES-D) and Short Form 36 health questionnaires (SF-36 general health domain). An area-level SES measure, relative location factor, was derived from hedonic regression models using residential property features but blind to location. Growth curve models with latent variables were fitted to data.

Results: Waist circumference, BMI and depressive symptoms increased over time. General health and relative location factor decreased. Worsening general health and depressive symptoms predicted worsening waist circumference and BMI trajectories in covariate-adjusted models. Diminishing relative location factor was negatively associated with waist circumference and BMI trajectories in unadjusted models only.

Conclusions: Worsening depressive symptoms and general health predict increasing adiposity and suggest the development of unhealthful adiposity might be prevented by attention to negative changes in mental health and overall general health.

Fig 1. Full path diagram of the growth curve model for waist circumference.

This path diagram illustrates the conceptual model of waist circumference trajectories as predicted by general health (GH) and Relative Location Factor (RLF) trajectories adjusting for various covariates. Subscripts 1 to 3 indicate measurements taken at waves 1 to 3; t₁ to t₃ represent unequal observation times; GH: General Health; RLF: Relative Location Factor; IRSD: Index of Relative Socioeconomic Disadvantage; POS: Public Open Space (# active parks); RFEI: Retail Food Environment Index. A path diagram model for predicting BMI trajectories can be done similarly.